Bottom Line:
Trans-mesenteric hernia is a form of internal hernia which is an extremely rare cause of intestinal obstruction in adults compared with the pediatric population.She was found to have a small congenital mesenteric defect with strangulated segment of ileum.The occurrence of trans-mesenteric hernia in adults is rare and difficult to be diagnosed clinically; thus, the patient's clinical features may lead to early surgical intervention in order to reduce morbidity and mortality.

Mentions:
Upon entering the peritoneal cavity, 2 l of hemorrhagic fluid was drained. A loop of ileum had herniated through a small mesenteric defect. A total of 180 cm ileum noted to be gangrenous with loss of peristalsis and absent pulsations (Fig. 1). Terminal ileum and the ileocecal junction were also nonviable. Pulsations of mesenteric vessels were intact. The mesenteric defect measuring 3 × 3 cm located about 4 cm from the mesenteric edge of mid-jejunum. There was no evidence of malrotation. A limited right hemicolectomy with extensive gangrenous small bowel resection was performed and a stapled side-to-side functional anastomosis created. The mesenteric defect mentioned earlier was closed with interrupted sutures. The patient recovered well from the surgery. She was allowed orally on day 3 post surgery (Figs 2–4).Figure 1:

Mentions:
Upon entering the peritoneal cavity, 2 l of hemorrhagic fluid was drained. A loop of ileum had herniated through a small mesenteric defect. A total of 180 cm ileum noted to be gangrenous with loss of peristalsis and absent pulsations (Fig. 1). Terminal ileum and the ileocecal junction were also nonviable. Pulsations of mesenteric vessels were intact. The mesenteric defect measuring 3 × 3 cm located about 4 cm from the mesenteric edge of mid-jejunum. There was no evidence of malrotation. A limited right hemicolectomy with extensive gangrenous small bowel resection was performed and a stapled side-to-side functional anastomosis created. The mesenteric defect mentioned earlier was closed with interrupted sutures. The patient recovered well from the surgery. She was allowed orally on day 3 post surgery (Figs 2–4).Figure 1:

Bottom Line:
Trans-mesenteric hernia is a form of internal hernia which is an extremely rare cause of intestinal obstruction in adults compared with the pediatric population.She was found to have a small congenital mesenteric defect with strangulated segment of ileum.The occurrence of trans-mesenteric hernia in adults is rare and difficult to be diagnosed clinically; thus, the patient's clinical features may lead to early surgical intervention in order to reduce morbidity and mortality.